HomeMy WebLinkAboutMortgage_Brasher .r,.R v STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS County Township Year
e ' FOR DEDUCTION FROM ASSESSED VALUATION
2016
L j: State Form 43709(R12/6-14) I J J 8.J
Prescribed by Department of Local Government Finance Fi M rk
au
INSTRUCTIONS: 2816
filed be filled in person or by mail. OC T 1;j L71'llfiled with:
Filing Dates: 1)Real Property:Must be completed and dated in the calendar year for which the deduction is sought.
Must be filed or postmarked with the County Auditor or County Recorder of the county where the ❑
/1
property is located on or before January 5 of the immediately succeeding calendar year. , ,,�� oun tY Auditor
2)Mobile/Manufactured Homes not assessed as Real Property: Must rile with the County Auditor of t ,�y County Recorder
county where the property is located during the twelve(12)months before March 31 of each:3.08 COUN—Y AUDITuR
deduction is sought.
See reverse side for additional instructions and qualifications.
Applicant(owner or contract buyer-see restrictions on reverse side)
Kyle Brasher and Kristin B sher
Ta • District Key number/legal description 26-18-36-300-002.606-024/1300 W. Record number Page umber
Chukar Hollow, Haubstadt, Indiana 47639 910/6 o:LY
As essed value of real property as of Mortgage/Contract Indebtedness unpaid as of Mortgage/Contract indebtedness unpaid as of Is the applicant the sole
March 1,current year March 1,current year date of application legal or equitable owner?
$163,000.00 ❑Yes ❑ No
If no.what is his/her exact share of interest? If owned with someone other than spouse,indicate with whom
If name on record is different than that of applicant,indicate below: Is the property in question: Annually Assessed
❑ Real Property ❑Annually Assessed
Mobile Home(IC 6-1.1-7)
Name of mortgagee or contract seller
Evansville Teachers Federal Credit Union
Address of mortgagee or contract seller(number and street,city, state, and ZIP code)
4401 Theatre Drive, Evansville, IN 47715
Name of assignee or other owner or holder of mortgage ,
Address of assignee(number and street,city,state, and ZIP code) VJ�.) t
Does applicant own property in any If yes,what county? ted If yes,state amount of
other county deduction
in Indiana? ❑ Yes ❑ No _ kW& El No
A person is not entitled to this deduction unless the person has I ass that is recorded in the county
recorder's office(including any home equity line of credit that is Jr the deduction.
COUNTY AUDITOR
Deduction approved in the amount of:
20 20 20 20 20 20 20
Signature of County Auditor County Date(month,day,year)
I/We certify under penalty of perjury that the above and foregoing information is true and correct and that the applicant is a resident of Indiana and
owner/contract buyer of the aforementioned property on date application is filed.
S -ature owner's full name) Date(month,day,year)
m
6 /< .. e . ' 10-1-Ib
:
F I resident a.dress of applicant(n• bet nd street,city,state,a,fr'code)
1300 W Hunters Crossing, Haubstadt, IN 47639
Person authorized by duly executed Power of Attorney or by IC 6-1.1-12-0.7 Date(month,day,year)
Address of authorized person(number and street, city, state,and ZIP code)
The penalties for perjury can include imprisonment up to two and a half years and a fine not to exceed$10,000.